From a population survey of 2865 subjects, test characteristics of a number of clinical findings relating to knee osteoarthritis were calculated against the standard of radiographic diagnosis. The clinical findings included from the history were age, gender, current pain in the knee, swollen knee, pain in both hands, morning stiffness, osteoarthritis in any joint, pain or stiffness, or both, in knees or hips when rising from seated position, and pain in knees or hips while climbing stairs; and from the physical examination: Quetelet's index, Heberden's nodes, bony enlargement, palpable effusion, soft tissue swelling, limitation of knee function, pain with knee flexion, bony tenderness and, finally, the latex fixation test. Of 18 clinical variables, all but Heberden's nodes, palpable knee effusion, pain in both hands, and latex fixation test showed a significant association after adjustment for age. Neither one single variable nor a combination could predict radiographic osteoarthritis of the knee with reasonable accuracy and thus be applicable in clinical practice. The x ray film, therefore, keeps its place in the diagnosis of knee osteoarthritis in general practice as well as in epidemiological research.
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